The Push for Electronic Medical Records

• Former President George W. Bush claimed that electronic medical records could improve the efficiency of maintaining records, and in his words "prevent medical error and needless costs." The push to encourage doctors to implement electronic medical records has continued with the administration of President Barack Obama. In 2009, President Obama introduced legislation that would grant an incentive of $40,000 for each physician who introduced electronic medical record keeping in her practice.
  
  

Successful Implementation

• The Cleveland Clinic represents an example of successful introduction of electronic medical records. Patients at the Cleveland Clinic can use the Internet to receive second opinions for a diagnosis of cancer, heart disease and other conditions; doctors order prescriptions through the electronic medical records system, which makes it easier to spot possible drug interactions; and nurses track patients as they go through their course of treatment at the hospital.
  
  Veterans Affairs has also implemented an electronic medical records system, with all its primary care physicians using the same system, which eliminates the problem of software incompatibility. Like the Cleveland Clinic, the VA has realized reductions in medical errors and increased cost efficiency.
  
  

Implementation Costs and Concerns

• However, many physicians remain resistant to implementing electronic medical records. One major source of resistance is the extensive time and cost involved with conversion of paper records. An estimate as high as $36,000 for each physician practice to convert paper records to electronic records was reported in a study by Robert H. Miller and Ida Sim and published in the journal Health Affairs.
  
  Another source of resistance by physicians to electronic medical records is the perceived restrictiveness of electronic medical records. According to Harvard physician Jerome Groopman, such restrictiveness prevents a free dialogue with the patient, "which can be key to making the correct diagnosis and to understanding which treatment best fits a patient's beliefs and needs."
  
  

Compatibility and Maintenance

• As with any new technology, there would be a learning curve involved for implementing electronic medical records for everyone involved. Compatibility between different record keeping systems is another source of potential concern. As of 2008, there was no single standard for implementing electronic records. One medical practice may use one system, while a specialist could use an entirely different, incompatible system.
  
  

Security and Privacy

• Additionally, the introduction of electronic medical records would also make it necessary to put a software and hardware maintenance schedule in place. Downtime would not be an acceptable option, nor would lost records. This would make it necessary to have a reliable backup system in place. Patient privacy in the event of breaches in data security would also need to be adequately addressed.